scholarly journals Perforated mitral valve aneurysm after aortic valve replacement due to inadvertent suturing of the anterior mitral leaflet

2004 ◽  
Vol 27 (2) ◽  
pp. 90-90
Author(s):  
Richard A. Kerensky ◽  
Vedat Davutoglu ◽  
Serdar Soydinc ◽  
Yusuf Sezen ◽  
Mehmet Aksoy
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Leaflet ◽  
Anterior Mitral Leaflet

Concomitant Gerbode-Like Defect and Anterior Mitral Leaflet Perforation after Aortic Valve Replacement for Endocarditis

2013 ◽  
Vol 30 (8) ◽  
pp. E231-E235 ◽  
Author(s):  
Cüneyt Toprak ◽  
Gokhan Kahveci ◽  
Suzan Akpinar ◽  
Mehmet Mustafa Tabakçi ◽  
Yeliz Güler
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Leaflet ◽  
Anterior Mitral Leaflet

scholarly journals Iatrogenic Mitral Valve Perforation following CABG and Aortic Valve Replacement: A Rare Complication detected by Post-bypass Transesophageal Echocardiography

2014 ◽  
Vol 2 (2) ◽  
pp. 75-76 ◽  
Author(s):  
Sarin Mathew ◽  
Ravi Raj
Keyword(s):  
Coronary Artery ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Transesophageal Echocardiography ◽  
Valve Replacement ◽  
Rare Complication ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Mitral Leaflet

ABSTRACT Iatrogenic mitral valve perforation following aortic valve replacement is a rare complication. We present a case of anterior mitral leaflet perforation following coronary artery bypass grafting (CABG) and aortic valve replacement detected by intraoperative transesophageal echocardiography (TEE). A 57-year-old male patient with preoperative diagnosis of coronary artery disease, sclerodegenerative aortic valve with severe aortic stenosis and mild central mitral regurgitation (MR) underwent CABG and aortic valve replacement. A post bypass TEE in midesophageal long axis view showed an additional MR jet across the body of the anterior mitral leaflet. We present intraoperative TEE images with a discussion on role of TEE in detection of mitral valve perforation and surgical decision making. Abbreviations AVR: Aortic valve replacement C ABG: Coronary artery bypass grafting 2D: Two-dimensional MR: Mitral regurgitation TEE: Transesophageal echocardiography TTE: Transthoracic echocardiography How to cite this article Raj R, Mathew S, Puri GD. Iatrogenic Mitral Valve Perforation following CABG and Aortic Valve Replacement: A Rare Complication detected by Post-bypass Transesophageal Echocardiography. J Perioper Echocardiogr 2014;2(2):75-76.

Balloon-Augmented Leaflet Modification With Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction and Laceration of the Anterior Mitral Leaflet to Prevent Outflow Obstruction: Benchtop Validation and First In-Man Experience

2021 ◽  
Author(s):  
Emily Perdoncin ◽  
Christopher G. Bruce ◽  
Vasilis C. Babaliaros ◽  
Dursun Korel Yildirim ◽  
Jeremiah P. Depta ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Left Ventricular ◽  
Mitral Leaflet ◽  
Outflow Obstruction ◽  
Anterior Mitral Leaflet ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Mitral Valve Replacement

Background: Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction (BASILICA) and laceration of the anterior mitral leaflet to prevent outflow obstruction (LAMPOON) reduce the risk of coronary and left ventricular outflow obstruction obstruction during transcatheter aortic valve replacement and transcatheter mitral valve replacement. Despite successful laceration, BASILICA or LAMPOON may fail to prevent obstruction caused by inadequate leaflet splay in patients having challenging anatomy such as very small valve-to-coronary distance, diffusely calcified, rigid leaflets, or undergoing transcatheter aortic valve replacement inside existing transcatheter aortic valve replacement. We describe a novel technique of balloon-augmented (BA) leaflet laceration to enhance leaflet splay. Methods: We measured the incremental leaflet splay from BA-BASILICA in vitro. From November 2019 to March 2021, 16 patients underwent BA-BASILICA and 4 BA-LAMPOON at 3 centers. Results: BA-BASILICA increased benchtop leaflet tip splay 17%, maximum splay angle 30%, and splay area 23%, resulting in a more rounded apex and larger effective area. Sixteen patients at risk for inadequate BASILICA leaflet splay, including 4 transcatheter aortic valve replacement inside existing transcatheter aortic valve replacement, underwent BA-BASILICA. All had successful leaflet laceration. One had coronary obstruction requiring immediate orthotopic stenting. Two underwent elective orthotopic coronary stenting through the transcatheter valve cells for leaflet prolapse without coronary ischemia. There were no deaths during the procedure or at 30 days. Four patients at risk for inadequate anterior mitral leaflet splay underwent BA-LAMPOON. All had successful target leaflet laceration without left ventricular outflow obstruction obstruction or procedural death. One died within 30 days. Conclusions: BA leaflet laceration enhances leaflet splay in vitro and may allow transcatheter aortic valve replacement and transcatheter mitral valve replacement in patients otherwise ineligible for traditional BASILICA or LAMPOON due to challenging anatomy.

scholarly journals Perforation of the Anterior Mitral Leaflet After Aortic Valve Replacement With Root Enlargement

2017 ◽  
Vol 104 (4) ◽  
pp. e345-e346 ◽  
Author(s):  
Ersin Kadirogullari ◽  
Burak Onan ◽  
Salih Guler ◽  
Korhan Erkanli
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mitral Leaflet ◽  
Anterior Mitral Leaflet

scholarly journals Selected Abstracts of the TEEPGI 2014 Workshop

2014 ◽  
Vol 2 (1) ◽  
pp. 42-48
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Severe Aortic Stenosis ◽  
Mitral Leaflet ◽  
Axis View

ABSTRACT Mitral valve perforation is most commonly due to infective endocarditis. Iatrogenic mitral valve perforation following aortic valve replacement has not been described previously. A 57 years male patient presented with complaints of progressive dyspnea on exertion and occasional palpitations. A preoperative diagnosis of severe aortic stenosis, sclerodegenerative aortic valve with normal left ventricle function was made on transthoracic echocardiography. A coronary angiogram showed single vessel disease involving proximal left anterior descending artery causing 80% stenosis. The patient was planned for aortic valve replacement (AVR) and CABG. Pre bypass TEE showed bicuspid aortic valve, thick, calcified, severe aortic stenosis and normal left ventricle systolic function. Mitral valve was morphologically normal with mild central mitral regurgitation jet. Patient underwent CABG and AVR under cardiopulmonary bypass support. Post CPB TEE examination showed 2 jets of mitral regurgitation in midesophageal aortic long-axis view (Fig. 1). There was a mild central MR jet and an additional mild MR jet from the body of anterior mitral leaflet. Transgastric short axis view showed turbulence in the region of A1 scallop of anterior mitral leaflet. We present the intraoperative TEE images of the patient with a discussion on the role of TEE in detection of mitral valve perforation and surgical decision making.

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